title: Adoption of CT colonography by US hospitals.
abstract: OBJECTIVE
  Computed tomographic colonography (CTC) is a new noninvasive technology proposed as an option for colorectal cancer screening. The purpose of this study was to identify the percentage of US hospitals that offered CTC between 2005 and 2008 and factors that motivated or impeded adoption.
  
  
  METHODS
  Data on the provision of colorectal cancer screening services by nonfederal, general hospitals were analyzed using the 2005 to 2008 American Hospital Association annual surveys. Additionally, in 2009, exploratory interviews were conducted with representatives from radiology departments at 9 hospitals; 6 that provided CTC and 3 that did not.
  
  
  RESULTS
  In 2008, 17% of hospitals offered CTC, up from 13% in 2005. Sixty-nine percent of hospitals that offered CTC in 2008 also offered optical colonoscopy services. Factors motivating the adoption of CTC included a desire to provide an alternative screening option for frail, elderly patients and patients with failed optical colonoscopy; long waits for optical colonoscopy; and promising evidence on CTC published in peer-reviewed literature. Lack of reimbursement was a commonly cited barrier.
  
  
  CONCLUSIONS
  Growth of CT colonographic services at US hospitals occurred even in the absence of Medicare coverage or agreement among national guideline-setting organizations regarding CTC's use in screening. Almost one-third of hospitals that offer CTC do not offer optical colonoscopy and may not be prepared to provide adequate follow-up for patients with failed CTC.
authors.affiliation: Institute for Healthcare Studies, Northwestern University, Feinberg School of Medicine, Chicago, Illinois 60611, USA. mmchugh@gwmail.gwu.edu
authors.forename: Megan
authors.initials: M
authors.lastname: McHugh
authors.forename: Awo
authors.initials: A
authors.lastname: Osei-Anto
authors.forename: Carrie N
authors.initials: CN
authors.lastname: Klabunde
authors.forename: Barbara A
authors.initials: BA
authors.lastname: Galen
mesh_terms: D023881:Colonography, Computed Tomographic / Q000706:statistics & numerical data*; D015179:Colorectal Neoplasms / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D006761:Hospitals / Q000706:statistics & numerical data*; D006801:Humans; D008403:Mass Screening / Q000706:statistics & numerical data*; D014481:United States / Q000453:epidemiology; D014600:Utilization Review